How are migraines diagnosed?

There are no specific diagnostic tests such as X-rays or blood tests to tell if your headaches are migraines. A diagnosis of migraine is confirmed only after your doctor carefully examines your headache symptoms and history. She may decide you need to have tests to make sure your headaches are not caused by some other medical condition. Most people with headaches won't need to have blood tests, X-rays, or special tests such as computed tomography scans (CT scans) or magnetic resonance imaging scans (MRI scans). These tests are usually reserved for patients whose headache histories or examinations suggest that their headaches are not typical migraines but may be due to other medical problems.

Computed tomography (CT scan): A computerized axial tomography scan, or CT scan, is an x-ray procedure which combines many x-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. An intravenous (into the veins) dye is injected into the individual. Then the patient is placed under a large donut-shaped x-ray machine, which takes x-ray images at many different angles around the body. These images are processed by a computer to produce cross-sectional pictures of the body. In migraine patients, a CT scan is performed to rule out an underlying brain abnormality, such as a tumor, when migraines are new or when there is a change in their character or frequency. CT scans may not be as reliable as newer diagnostic techniques, such as magnetic resonance imaging (MRI), but are less expensive.

Electroencephalogram (EEG): An electroencephalogram (EEG) records electrical signals originating in the brain (called brain activity). This test is used to detect malfunctions in brain activity, such as seizures or migraines.

Magnetic resonance imaging (MRI): An MRI (magnetic resonance imaging) scan is a radiology technique that uses magnetism, radio waves, and a computer to produce images of body structures. The MRI scanner is a tube surrounded by a giant circular magnet. The patient is placed on a moveable bed that is inserted into the magnet. The patient may be given a sedative, such as alprazolam (Xanax®), to decrease anxiety and stress associated with the procedure. The image and resolution produced by MRI is quite detailed and can detect tiny changes of structures within the body. An MRI in patient's with migraines may be performed for a more complete evaluation of the brain, and can visualize blood vessels in the brain to detect aneurysms (tears in blood vessels) and other vascular abnormalities that can be causative agents in migraines.

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There is no definitive test to distinguish a migraine headache from any other type of head pain so your doctor will rely on your medical history and physical examination, along with a detailed discussion of symptoms and triggers. Other testing, such as CT scan, is rarely necessary.

Diagnosing migraines can be difficult because the symptoms often are extreme and can resemble other serious conditions, including heart attack, stroke, meningitis and brain tumors. Most migraine conditions are diagnosed after a doctor takes an extensive family history, considers the patient's symptoms and rules out other possible conditions.

Your head is killing you -- but does that mean it's a migraine? Thanks to clear symptoms, migraine headache are relatively easy to spot, says integrative medicine expert and Dr. Oz Show guest Mosaraf Ali. In this video, he explains how doctors make the diagnosis.